The journey of liver transplantation: Milestones covered and
Liver transplantation has now become an established approach for managing end-stage liver diseases, and the journey in the complex procedure of liver transplantation has come a long way, witnessing many ups and downs. Better understanding of the physiological and pathological changes in the context of end-stage liver disease has made anesthesia, an important denominator for the successful outcome of this complex surgical procedure. As the prevalence of the liver disease is rising, especially with hepatitis C infection, alcoholic
nonalcoholic-related liver disease, and hepatocellular carcinoma in an aging population, there is a significant impact on the perioperative and intensive care services. Perioperative mortality during liver transplantation is of concern, and it increases in proportion to disease severity but is affected by functional status, nutritional impairment, other comorbidities, and requirement for organ support. Model for End-stage Liver Disease (MELD) score is now commonly used to allocate and prioritize patients for transplant and has gained more importance than the conventional Child-Pugh scoring.[1] MELD score uses patient's serum bilirubin, prothrombin time, and creatinine to predict survival based on a calculation. Serum sodium concentration has been incorporated in the UK model of MELD to make it more meaningful...;year=2016;volume=32;issue=3;spage=283;epage=285;aulast=Murthy